Dropped Nucleus-When Does it Happen and what should be Done-A Review in one Center

Abstract

AIM: Due to the recent increase in dropped nuclei and poor visual outcome in patients in our hospital, this study was done to identify causes and associations of this problem in order to improve patients’ outcomes.

MATERIALS AND METHODS: Retrospective analysis of dropped nucleus from June 2014 to January 2015 was done. Type of cataract, grade of surgeon, ocular and systemic comorbidities, point of occurrence of dropped nuclei, subsequent complications and management and final visual outcome were noted.

RESULTS: Eight dropped nuclei occurred during various stages of cataract surgery, more among senior surgeons. Not stopping phaco once a posterior capsule rupture (PCR) occurred, lead to dropped nucleus. Pars plana vitrectomy (PPV) was either not done or done beyond 1 week in some –leading to rise in intraocular pressure with resultant punctate epithelial erosions and retinal detachment. Visual outcome was poor with dropped nucleus and delayed PPV.

CONCLUSION: Dropped nucleus occurs even among experienced surgeons, but a PCR must be recognized and appropriate steps taken to prevent a nucleus from dropping. Once a nucleus has dropped, early PPV should be done to prevent further complications that lead to poor vision.